electronic transaction dispute. Mail: ME, Card Disputes, Reply Paid 1345, Melbourne, VIC 8060 Email:
[email protected] Fax: (03) 9708 4740 For any enquiries contact us on 13 15 63 or visit mebank.com.au Section 1 - Your account details Account type: Credit card Transaction Account Savings Account Personal Loan Home Loan Card number (if applicable) Account number (not required for credit card disputes) Section 2 - Account holder details Title (Mr/Mrs/Miss/Ms/other) Given name(s) Family name Residential address (P.O. Box addresses are not acceptable) State Postcode Mobile Home phone Work phone ( ) ( ) Section 3 - Last valid transaction details Date Time Amount Location D D M M Y Y : am/pm $ . Type of transaction: EFTPOS ATM Internet inc. Mobile App Phone banking Bank@Post Credit card purchase Section 4 - Disputed transaction details (if there are more than 3 transactions, please attach details) Transaction 1 Date Time Amount D D M M Y Y : am/pm $ . ATM operator fee $ . Merchant name Location Type of transaction: EFTPOS ATM Internet inc. Mobile App Phone banking Bank@Post Credit card purchase Transaction 2 Date Time Amount D D M M Y Y : am/pm $ . ATM operator fee $ . Merchant name Location Type of transaction: EFTPOS ATM Internet inc. Mobile App Phone banking Bank@Post Credit card purchase Transaction 3 Date Time Amount D D M M Y Y : am/pm $ . ATM operator fee $ . Merchant name Location Type of transaction: EFTPOS ATM Internet inc. Mobile App Phone banking Bank@Post Credit card purchase Have you authorised someone to use your card? Yes please complete Section 5 No go to Section 6 Members Equity Bank Limited ABN 56 070 887 679.